Social Justice

Andrew Linden, Carly Witherell, and Judith Leon

Providing accessible Healthcare

Healthcare in Arkansas

Arkansas Children’s Hospital (ACH) is not only the only major children's hospital in Arkansas, a state with over 710,000 children, but it is one of the countries largest childrens hospitals. However, ACH is located in the center of Arkansas. This makes it difficult for children living in the corners of the state to receive adequate health care.

Because of this distance to care, Arkansas has startling statistics regarding children’s healthcare.

40% of children ages 2 to 17 lack sufficient access to medical or dental care
35,000 children are without health insurance

ACH shares these statistics with members who attend their mission center oritentations to really drive home why they do what they do. ACH has made it their goal to create an impact in every area of Arkansas and be a "Champion of Kids".

How does Arkansas Children's Hospital live out this goal?

ACH has created programs to extend their impact past Little Rock. They used their values to implement their vision of transforming healthcare in Arkansas to carry out their mission of championing children. Every district in Arkansas has connections to Arkansas Children's whether it be a clinic, hospital, or a non-physical program.

Arkansas Children's Northwest

Arkansas Children's Northwest is an extension of ACH located in Springdale, Arkansas. This location means 70 percent of Northwest Arkansas residents can reach Arkansas Children’s services in 30 minutes or less. To put this into perspective, children would have to travel three hours to ACH before Arkansas Children's NW was opened. They provide services such as:

Access to all the same services at Arkansas Children’s flagship hospital in Little Rock
Education and outreach programs
Mobile health programs
Pediatric Research Institute
School-based health solutions
Statewide transportation to bring children in critical condition to life-saving treatments
Telehealth services

Additionally, they are the only hospital in the area that provides:

Pediatric emergency department
Primary and specialty care pediatric clinic services
Full range of ancillary and diagnostic services, child life, social work, and pastoral care programs
Helicopter landing pad and refueling station for Angel One, one of the nation’s leading pediatric intensive care transport services with more than 2,000 transports annually
A state-of-the-art pediatric surgery unit including 5 operating rooms

Clinics

ACH provides clinics all around the state of Arkansas. Two of the main ones are SW Little Rock and Jonesboro.

Southwest Little Rock Community Clinic

While this clinic is in Little Rock, it has the focus of providing accessible health care to Spanish-speaking families. A bilingual staff provides care for the thousands of children expected to attend the clinic due to anything from well-child visits to treatment for acute illnesses.

Jonesboro Clinic

This clinic allows ACH to provide treatment options to children in Northeast Arkansas. The clinic provides:

Asthma (Telemedicine)
Cardiology
Developmental Rehab
Ear, Nose & Throat
Genetics
Surgery Clinic
Orthopedics
Neurology
Neurosurgery
Sleep Disorders
Urology

A physician skyping into a consultation via Telehealth.

Our team standing in front of Angel One.

Additional services

Telehealth

ACH initiated a telehealth program for children and families too far away from care. This program allows parents to schdeule doctors appointments during their child's school day in their nurses office. The doctor will "skype" into the appointment and provide their care over the internet. This program has connected children and families to the care they need from all corners of the state.

ACH also provides financial counselors who help patients and their families understand and connect to their health care coverage. Interpreters for non-English speaking families also increase ability to get proper care.

Angel One

Lastly, a unique and life saving feature of ACH is their Mobile ECMO Program, called Angel One. Angel One consists of 4 ground ambulances and 2 helicopters, allowing them to provide transport for patients within a 250 mile radius of Little Rock. This expands the access to life saving care to all regions of Arkansas. We were able to see how this program works. A member of the Angel One team showed us both helicopters, took us to see all the supplies and equipment they use, introduced us to the rest of the team, and thoroughly explain what Angel One is. While we sadly didn't get to ride the helicopters, we were taught so much about this wonderful service provided by ACH.

Fostering better health services For Children

Statistics about Children's Health in Arkansas

Arkansas is ranked 41st in the United States for Children's Health
27.2% of Children under the age of 18 live in poverty
In 2014, 39 percent of Arkansas students had a BMI in the overweight or obese category
26% of households with children identify as food insecure
About 25% of Arkansas children are in need of routine dental care
11% of Arkansas believe their access to care is inconvenient
6.5 percent of children under the age of 19 lack coverage

What is being done about this?

The Arkansas Children's Hospital (ACH) presents these statistics in their Mission Center presentations/tours. ACH want to be a champion of children's health so they are actively trying to change these statistic to not only help the children within their state borders but children nationally. So, after complying and reviewing all the data they found, healthcare providers within Arkansas came together to make a change.

Oral Care

The ACH Staff in 2010 started a coalition to help support statewide oral health. The ACH staff operates three mobile dental vans that provide dental cares to patients all around the state. These vans focus on areas of the states furthest from access to care. The vans travel to schools where the kids can receive care during the school day. This program reaches over 50 schools a year and helps over 3,000 children get the proper oral care needed.

Mobile Dental vans expand oral care to children across the state.

Mobile food pantry helps reduce food insecurity within Little Rock.

Our team working at a program called "Meal and a Movie" This program provides dinner to individuals and families who are food insecure. Our team even got to work with children during the service time.

Food Insecurity

Arkansas was once leading the country in the amount of child food insecurity. However, with the help of the Arkansas Hunger Relief Alliance (AHRA), they are quickly raising their ranks. AHRA has help children get access to food by expanding the number of children eating breakfast in schools, expanding the eligibility for paid school meals, and has establish year-round meal sites.

Arkansas Children's Hospital (ACH) has also taken steps towards reducing child food insecurity. The hospital is partnered with Helping Hands food pantry to provide food to hungry patient families. Families staying in the hospital also receive meal assistance through programs. Lastly, ACH partnered with other organizations to bring a mobile food pantry to neighborhoods that visit the hospital most frequently.

Obesity

In 2015, Governor Hutchinson launched the Healthy Active Arkansas Initiative. This program encourages others to lead healthier lives by implementing a physical activity program into more than 700 schools. This program is essentially an app for teachers to use throughout the day. It works in 2-5 minute "brain breaks" into the day which include various exercise activities. This program increase activity minutes for more than 158,000 students.

Another program initiated by Arkansas Children's Hospital Community Outreach is their Fitness and Nutrition club (F.A.N). This program educates children about health and hygiene. ACH also supports a cooking class geared towards low-income residents to help them learn how to incorporate healthy meals at a low cost in their daily lives.

Advocating for Children's Health through public policy

Arkansas Advocates for Children and Families (AACF) was founded in 1977 by a group of Arkansans who believed that children needed an "independent force to provide information and education to parents and citizens about state policies towards children and families" (AACF website).

What their work includes;

Protecting Children. AACF plays a major role in challenging Arkansas juvenile justice and child welfare system.
Improving Children's Health. Created ARKids First, which provides children's health insurance to working families. Today, they focus on driving around the state enrolling all eligible children and extending more options to families who can't afford private insurance.
Fighting for Early Education and Out-of-School Opportunities. Work with partners across the state to ensure that high-quality public schools remain a top priority in the state's budget.
Promoting Economic Security. AACF has led efforts to make tax and budget system more balanced. Now they are working on securing a state earned income tax credit to help balance their regressive tax system.

To find out more about AACF you can visit their website; http://www.aradvocates.org/about-us/

ARKids First

Is a health insurance program that provides coverage for more than 70,000 children across Arkansas. It covers well-child checkups, eye exams, dental checkups and more. There are two coverage options based on family income.

Children's Health Insurance Program (CHIP)

Provides health insurance to families that do not qualify for Medicaid but can't afford private coverage either.
Some benefits covered through CHIP include:
- Routine check-ups
- Immunizations
- Doctor visits
- Prescriptions
- Dental and vision care
- Inpatient and outpatient hospital care
- Laboratory and X-ray services
- Emergency services

Children's Advocacy Centers of Arkansas

Community based facility which uses a multidiciplicary approach to reduce trauma to child victims of physical abuse, sexual abuse or neglect.
31,271 Cases investigated in Arkansas
What they provide;
- Forensic interviews: Trained interpreter, reduce the number of intereviews, higher conviction rates, better disclosure
- Family Advocacy: Family support, court preparation, connection to other services
- Community Awareness and Education: Mandates reporter trainings, prevention, body safety, internet safety, child care facilities
- Mental Health Program: Crisis intervention, long-term trauma-informed treatment
- Medical Exams: specialized exams for child abuse, collect important evidence, Providers with child abuse expertise, ensure health and safety of a child
- Who else is involved to help?
  - Local Law Enforcement
  - Local Prosecutting Attorney's Office
  - DHS- Department of Children and Family Services
  - Arkansas State Police
  - Mental Health Professionals
  - Specialized Medical Professions
  - Juvenille Court Systems
  - Community Partners
  - FBI
  - Military Investigators

For more information visit their website: https://www.cacarkansas.org/cac

ACH provides free-legal aid to qualifying families in partnership with the Arkansas Legal Community. This partnership is known as a Medical-Legal Partnership (MLP). This program intergrates lawyers as a vital component of the health care team. It sees to eliminate barriers to health care in order to help vunreable populations meet their basic needs and stay healthy.

How MLP has been used to adress social needs;

People with chronic illnesses are admitted to the hopsital less frequently. This has been posible by targeting the improvement of housing conditions.
People more commonly take their medications as prescribed
People report less stress and experience improvements in mental health
Less money is spent on health care services for the people who would otherwise frequently go to the hopsital, and use preventative health care increases.
Clinical services are more frequently reimbursed.

https://medical-legalpartnership.org/impact/

Reflection

As our group spent time at the hospital, the Ronald McDonald House, and at a event geared towards the homeless population, we witnessed first hand how the programs that ACH provides can affect others greatly.

While interacting with patients in the lobby and waiting rooms, families would tell us they traveled anywhere from 10 minutes to 3 hours for their appointment. This access to care is critical for a child's health. Children's chances are lowered at actually receiving the proper treatment the further they are away from that specific care. However, after listening to the Mission Center speech, we learned about so many programs that were initiated to reverse this problem. These programs initiated by the ACH Hospital and Foundation led us to be shocked at how much effort has gone in to be a champion of children.

When reflecting on the hard work Arkansas has put into their community, we came to the realization that Iowa is just as rural as Arkansas and could benefit from the programs that have enhanced access to care for children all around the state. In the future, we will be advocators for increased action towards making accessibility a priority here in Iowa.

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